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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMFL,-� ED FOR APPLICATION TO BE ACCEPTED - Date: / (a • J� T:-ermit Number: / SCANNED EIVED BY R E., Building Permaf&Uo licat on AUG 16 20 - g pp 's Planni g'and Development Services Permitting Buildi �g and Code Regulation Division �e�erti3'1er)t 2300 irginio Avenue, Fort Pierce FL 34982 St. LUCI c®Llnty, FL Phon�'1: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentia PERMIT APPLICATION FOR: J:�,,r- I Addres d h , 2'�V�.�c�0 V R b I Prope l' Tax ID #: 13 - 0 •- G 0 S- 0 a 3 9 -V v b 1 Lot No. Site Pla Project 1 Name:. Block No. i1 lame: Setbac 11 'is Front Back: Right Side: Left Side: i DETAfLE© DESCRIPTIO OF WORK. \N R w s 2?\Cc c_c_ t, L - A ' � C,c it II I CONSTRUCTIO tN�F@RMWEINi Additional work to be Dertormed under this permit- check all that aDD v: _MIechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ E I'ectric _ Plumbing _ Sprinklers. Generator Mt4_4 Roof Pitch Total SC Ft of Construction: ` k z>n Sq. Ft. of First Floor: Cost of onstruction: $ e ors Utilities: —Sewer —Septic Building Height: OWNER%L+SSCE: S©NTRACTO'R, Nameii1 lil Addre;'s: City: .'! Zip Code: Phone E-Maill Name: -?* I� (o x enw�� Company: p y: ► e�c L �L• Stater 3, m Fax: No. -7 7a - Sta - C09 to Address: City: State: Zip Code:' Fax: Phone No E'L1C-ec� ol� CsZ���,..r� .Cum Fill in Le simple Title Holder on next page ( if different E-Mail from t I e Owner listed above) State or County License If value df construction is 2500 or more, a RECORDED Notice of Commencement is required. I'I UP � , � � .N !. � SyT • U i" o L. LAW � F a,RM TON: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State:ii Zip: Phone "'` Zip: Phone: I. FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: _ Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibitl such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. igrrature�of�_®`wne, Lessee Contractor as Agent for v qer-., Signature of Contractor/License Holder rlk o �- STATE OF FLORIDA A STATE OF FLORIDA COUNTY OF GLCu� .qp� • y o;: COUNTY OF � m � The for oing instrui7nt was acknowledged fore e o The forgoing instrument was acknowledged before me I this day of 20) Oby o M� d this day of 20_ by re I� r) we �T (Name of person acknowledging) (Name of person acknowledging) N (Sig ture of Not Public- State of Flori a) (Signature of Notary Public- State of Florida ) / Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifi ati - Qn� Type of Identification Produced - ✓t/lC, Produced Commission No. (Seal) Commission No. (Seal) . REVIEWS FRONT ZONING SUPERVISOR' PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 712014